The National Institute of Neurological Disorders and Stroke (NINDS) is seeking to develop a Neurological Emergencies Treatment Trials (NETT) Network of Clinical Site Hubs. The Hubs will work with the NETT Clinical Coordinating Center to improve outcomes for patients with neurological emergencies through research. The clinical site Hubs will be regional consortia of emergency departments (ED) that will recruit patients and carry out phase III clinical trials. The Henry Ford Health System (HFHS) has a long commitment to both basic science and clinical research in neurological disorders and is a NINDS designated Stroke Center with 18 years of continuous funding. This proposal is a natural extension of our current work. The objective of this proposal is to demonstrate that the HFHS is an ideal Hub for the NETT Network. The specific aims are to create a flexible Hub with seven "spokes" at HFHS, to participate in research that improves patient care, to help create an enduring research network, to allow multi-specialty collaboration, and to foster research skills in young investigators that will allow them to pursue a career in clinical research. The Hub will be designed around the HFHS because it is a regional, integrated system of 6 area hospitals, 9 emergency departments, including 4 JCAHO certified stroke centers, and 36 clinics. It also includes a closed medical group of over 800 physicians with over 2.5 million outpatient visits and over 350,000 emergency department visits annually. The HFHS serves a wide variety of minorities, women, and children. The system is integrated through a central IRB, shared electronic medical record, standardized patient care and referral protocols, communication systems, and an integrated governance and leadership structure. A dedicated ambulance service (Superior Ambulance) interconnects the system. This proposal will use three hospitals and seven EDs. The method of implementation will be the Ford Neurological Emergencies Cross- disciplinary Team (Ford NEXT). This 28 member multi-specialty team with expertise in Emergency Medicine, Prehospital Care, the Neurosciences, Neuro- Intensive Care, Neuro-interventional Radiology, Trauma, Pediatrics, and Rehabilitation will implement and completely manage the clinical trials. The importance of this proposal is that the HFHS hub will build on a well established neuroscience foundation, rapidly complete studies in neurological emergencies, and improve patient care and outcomes. [unreadable] [unreadable] [unreadable]